Tricare Prime Remote... — The Bump
Military Families

Tricare Prime Remote...

My husband deployed earlier this year, and until the day he deployed we had the insurance through his work as our Primary and Tricare as our secondary.  Well the day he deployed we switched over to just Tricare because we couldnt afford the out of pocket at that point to keep the other insurance.  We found out I was pregnant in late September, and we officially got me in the DEERS system in late November. 

My question is, will Tricare cover all of my pregnancy expenses or will we be stuck with a huge bill?  My husband is in the Army Reserve so the only time we have tricare is when he deploys and since this is his first deployment we just are not sure how all this works.  And the closests office to talk to anyone about tricare is over 2 hours away and since im on travel restriction due to swelling and bp issues its impossible for me to travel there to ask them questions, and they dont like answer them over the phone for security reasons.

So would any of you ladies know if tricare will cover the expenses we have from this pregnancy or will we be stuck with a huge out of pocket on all of this?

Re: Tricare Prime Remote...

  • I believe Tricare does not see pregnancy as a pre existing condition and you should be covered. Ask your OB and hospital if they take Tricare. You won't need a referral on prime remote but you want to make sure your providers accept it so you're not considered out of network.

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    CJ 05/29/2013

  • My OB does accept tricare and we have had them listed there at the clinic since November, but they dont bill till the end of your pregnancy because theirs are packages which seems strange to me but thats just how this OB's office does it. 

    But thats a big help because I know non military insurances see pregnancy as a prexisting condition so its really good to know tricare does not!  :-)

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  • I just called them two days ago ( the day I got my BFP ) They said pregnancy is not a pre-existing condition. :) I was really worried about that, I had meant to call and get everything set up before we got pregnant. We have private insurance through my husbands work too, but Tricare covers A LOT better. They said for a family its a $300 deductable, 80/20 coverage and after you hit $1,000 out of pocket they cover 100%! I wish I had thought to call them before our mc, because that cost us more than it cost to have my son. Would have saved us alot of money. I may be wrong, but if your husband is active duty, don't you get a different kind of Tricare that pays better?? My friends that had active duty husband never seemed to pay a dime to have their kids.
    BFP #1 03/2010 EDD 11/18/2010 DD born 11/03/2010 BFP #2 12/02/2011 CP on 12/05/2011 BFP #3 12/28/2011 EDD 09/10/2012 Missed mc @ 9w3d on 02/09/2012 D&C 03/06/2012 BFP #4 04/24/2012 EDD 01/02/2013 CP on 04/29/2012
  • What you described sounds like tricare reserve select. If your husband is put on AD then you will receive tricare prime remote and not have a cost share. Also if you have private insurance still through your husband than you really should only use tricare as a secondary. They may deny your claims if they find out you have another form of insurance. 

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    CJ 05/29/2013

  • I switched to Tricare Prime about 7 months into my current pregnancy.   The nearest base actually doesn't have a maternity ward, so I am going to an off-post OB and will be delivering here locally as well.  My DH is ARNG Reserve as well, and we have had no problems w/ the switch since he's active now, and as far as cost, it's the same as any other active duty soldier, so no real deductible worries for us.

    Only thing I would check on is if you need a referral (I switched doctors, because I did need a referral to an approved OB, and my previous OB did not accept tricare as a form of insurance--would have had to pay out of pocket).  You can set up an online login for Tricare's website and ask questions there as well--it may be easier to get a full response, as it's a secure site that you have to login to rather than the phone.  Hope this helps! 

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